Individual
JETIA LASONJA SCALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
8613 OLD KINGS RD S STE 602, JACKSONVILLE, FL 32217-4863
(904) 504-5225
Mailing address
8613 OLD KINGS RD S STE 602, JACKSONVILLE, FL 32217-4863
(904) 504-5225
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11036888
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
11036888
FL
Other
Enumeration date
12/20/2024
Last updated
03/22/2025
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